Organization
EHK ENDOVASCULAR PLLC
Active
Other names
EHK Endovascular PLLC, Michigan Outpatient Vascular Institute LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS H KASSAB M.D. (OWNER)
(313) 359-8300
Entity
Organization
Contact information
Practice address
5250 AUTO CLUB DR STE 170, DEARBORN, MI 48126-2619
(313) 359-8300
(313) 359-8305
Mailing address
5250 AUTO CLUB DR STE 170, DEARBORN, MI 48126-2619
(313) 359-8300
(313) 359-8036
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301047006
MI
207RI0011X
Interventional Cardiology Physician
4301047006
MI
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H27482
BCN GROUP PIN
MI
01
—
DT5132
RAILROAD MEDICARE GP PTAN
MI
Enumeration date
05/04/2011
Last updated
01/12/2024
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